60 – 90 days is an appropriate time frame. This is due to the following:

1)    It takes at least 6 – 8 weeks for the physiology to return back to normal.
2)    The ovary needs 60 – 70 days to recruit a new cohort of follicles.
3)    It takes a good 6 – 8 weeks to get over and work through the  emotional trauma of a failed cycle

Recruitment of primary oocytes in the ovary ( get the follicles to pre-antral stage) is a paracrine function of the ovary and is independent from FSH or LH hormones. It is therefore an ongoing process that is not influenced by external factors like the COC pill etc. I therefore have no idea why clinics “jump” from one cycle to the next.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

A “chemical” pregnancy, or more commonly used term “biochemical” is when the embryo has implanted into the endometrium, but is too early to be detected on ultrasound and the only way the diagnosis can be made is by blood test.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

The ideal time is 60 – 90 days.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

It all depends on the grade of the varicocele, whether it is stage 1,2 or 3.
From a fertility perspective, varicocelectomy is only indicated under the following circumstances:
1)    The varicocele is clinically palpable
2)    The couple has known fertility
3)    The female partner has normal fertility or a potentially treatable cause for infertility
4)    The male partner has abnormal semen parameters

ALL of the above have to be present to justify surgery from a fertility perspective.
There are 2 ways of doing the procedure:
1)    Open surgery
2)    Embolization ( the preferred method)

Complications are bleeding, infection and cyctocele development.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

In order to answer the question, I shall need more info, namely:
1)    The chromosomal analysis
2)    The result of the testicular biopsy
3)    The results of the clinical examination

We are not aware of urologists specializing in infertility as this is usually handled by an infertility unit.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

The best around is probably Silbermann in the USA. I shall get the contact details and post it  on the site.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

The count has not increased. What you are looking at when it has been prepared for AI is a concentrated count.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

Total count on full SA being 10 mil/ml is on the low side. One would therefore be inclined to move onto IVF/ICSI sooner rather than later.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

There are numerous reasons for heavy menstrual bleeding – too many to mention here. The secret is to establish a firm diagnosis and then to treat accordingly.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -

Cramping post AI is not necessarily a bad sign. It is due to the presence of the sperm and media inside the uterus. A uterus always aims to be empty and therefore contracts in order to rid itself of anything on the inside but instead sucks the sperm into the fallopian tubes. It therefore varies from cycle to cycle and also might be due to a change in the media the sperm is prepared in.

With regards to the catheters: There are many types of insemination catheters. Some harder or softer than others. Which one is used usually depends on the clinician, in other words which he/she is comfortable in using.

- Week 18 answers kindly provided by Dr. Stephan Volschenk -